NUR 212: Pregnancy-Related Complications and High-Risk Conditions

Comprehensive vocabulary flashcards covering pregnancy-related complications, hypertensive disorders, placental abnormalities, hemorrhagic emergencies, and clinical interventions from NUR 212 lecture materials.

High-Risk Pregnancy

A pregnancy characterized by risk factors or complications that place the pregnant client and/or the fetus at risk for poor health outcomes.

Healthy People 2030 Objectives for Maternal Health

National health objectives aimed at reducing severe maternal complications of pregnancy identified during labor and delivery hospitalizations and reducing preterm births.

Spontaneous Abortion (Miscarriage)

The loss of a pregnancy before the fetus is viable at less than $20\,\text{weeks}$ of gestation, with the majority occurring prior to $12\,\text{weeks}$.

Hemorrhagic Conditions of the First Half of Pregnancy

The three primary causes of bleeding occurring prior to $20\,\text{weeks}$ of gestation: spontaneous abortion, ectopic pregnancy, and gestational trophoblastic disease.

Threatened Abortion

A type of spontaneous abortion presenting with vaginal bleeding and cramping (dysmenorrhea) while the cervix remains closed, meaning pregnancy loss is not inevitable.

Inevitable Abortion

A spontaneous abortion in progress where the cervix is dilated and open, indicating that pregnancy loss cannot be prevented.

Incomplete Abortion

A spontaneous abortion in which some products of conception are expelled, but portions of fetal or placental tissue remain inside the uterus.

Complete Abortion

A spontaneous abortion where all products of conception are completely expelled, leaving the uterus entirely empty.

Missed Abortion

A pregnancy loss where the embryo or fetus has stopped developing and died, but the body has not passed the tissue and it remains inside the uterus.

Septic Abortion

A spontaneous or induced abortion complicated by severe infection within the uterus or pregnancy-related tissues.

Dilation and Vacuum Curettage (D&C)

A procedure in which the cervix is dilated and the uterine walls are scraped with a curette to remove retained tissue; client teaching requires reporting bleeding that saturates more than one pad in an hour.

Dilation and Evacuation (D&E)

A second-trimester surgical procedure involving cervical dilation and evacuation of fetal parts and placental tissue using specialized forceps and instruments.

Ectopic Pregnancy

An emergency condition occurring in $1\text{ in every }50\,\text{pregnancies}$ ($2\%$ of all pregnancies) where a fertilized ovum implants outside the uterine cavity.

Gestational Trophoblastic Disease (Hydatidiform Mole)

An abnormal cellular growth occurring in $110\text{--}120\text{ per }100{,}000\,\text{pregnancies}$ where trophoblastic tissue develops into a placenta without a viable fetus; requires evacuation and regular follow-up for $1\,\text{year}$ to screen for malignant choriocarcinoma.

Cervical Insufficiency

Premature, painless dilation of the cervix of unknown etiology or resulting from prior cervical damage, which can lead to pregnancy loss before fetal viability.

Cervical Cerclage

A surgical suture placed around the cervix between $12\text{ and }16\,\text{weeks}$ of gestation for a known history of cervical insufficiency (or up to $24\,\text{weeks}$ in an emergency) to maintain closure until approximately $37\,\text{weeks}$.

Hyperemesis Gravidarum

A severe form of nausea and vomiting extending past normal morning sickness (usually resolving by week $20$) characterized by weight loss $> 5\%$ of prepregnancy body weight, dehydration, hypokalemia, and metabolic acidosis or alkalosis.

Placenta Accreta

A placental attachment disorder where chorionic villi attach directly to the myometrium rather than remaining restricted within the decidua basalis.

Placenta Increta

A placental abnormality characterized by chorionic villi invading directly into the myometrium.

Placenta Percreta

A severe placental abnormality in which chorionic villi invade completely through the myometrium and penetrate the perimetrium (uterine serosa).

Placenta Previa

Implantation of the placenta in the lower uterine segment near or covering the internal cervical os, presenting with painless, bright red vaginal bleeding during the second or third trimester.

Digital Vaginal Examination Restriction in Placenta Previa

The clinical rule strictly prohibiting digital or manual vaginal exams in patients presenting with undiagnosed third-trimester bright red vaginal bleeding to avoid puncturing or tearing the placenta.

Placental Abruption (Abruptio Placentae)

The premature separation of a normally implanted placenta from the uterine wall at or after $20\,\text{weeks}$ of gestation, causing visible or concealed hemorrhage and hematoma formation.

Five Classic Signs of Placental Abruption

The clinical triad and associated findings: vaginal bleeding, abdominal and low back pain, uterine irritability, high uterine resting tone, and localized uterine tenderness.

Gestational Hypertension (PIH)

Blood pressure elevation occurring after $20\,\text{weeks}$ of pregnancy without proteinuria that resolves by $12\,\text{weeks}$ postpartum.

Preeclampsia

A systemic condition characterized by generalized vasospasms that decrease blood flow to all maternal organs and the placenta, presenting as hypertension (systolic $> 140\,\text{mm Hg}$ or diastolic $> 90\,\text{mm Hg}$) with or without proteinuria, cured by delivery.

Preeclampsia with Severe Features

Preeclampsia accompanied by systolic BP $\ge 160\,\text{mm Hg}$ or diastolic BP $\ge 110\,\text{mm Hg}$ on two occasions at least $4\,\text{hours}$ apart, persistent headache, visual disturbances, RUQ pain, pulmonary edema, or severe laboratory derangements.

Intrauterine Growth Restriction (IUGR)

A fetal complication seen in preeclampsia, chronic hypertension, and smoking/cocaine use caused by vasoconstriction that leads to poor placental perfusion and small fetal size.

Eclampsia

The progression of preeclampsia to the onset of generalized tonic-clonic seizures, often preceded by facial twitching and a rigid body.

Magnesium Sulfate

A central nervous system depressant and smooth muscle relaxant administered to prevent seizures in preeclampsia and protect the fetal brain, maintaining a therapeutic level between $1.3\text{ and }2.1$.

Calcium Gluconate

A mineral replacement and antidote for magnesium sulfate toxicity that is administered via slow intravenous push over $2\,\text{minutes}$.

HELLP Syndrome

A severe pregnancy complication characterized by Hemolysis (erythrocyte destruction), Elevated Liver enzymes (obstructed hepatic blood flow from fibrin deposits), and Low Platelets (consumption due to vascular damage).

Disseminated Intravascular Coagulation (DIC)

A life-threatening hematologic disorder secondary to preeclampsia, HELLP, or sepsis wherein pro-coagulation and anti-coagulation pathways are simultaneously activated, exhausting clotting factors and platelets and causing widespread bleeding from orifices and a boggy uterus.

Hemolysis

The fragmentation and distortion of red blood cells as they pass through damaged and constricted blood vessels, resulting in burr cells or schistocytes on peripheral smear.